Minister of Health and Welfare Chung-Liang Shih has proposed amending the National Health Insurance Act to allow balance billing for off-patent originator drugs with generic alternatives already on the market. Under the proposal, National Health Insurance (NHI) would continue to provide basic reimbursement, while patients choosing higher-priced originator drugs would pay the difference. The proposal has not yet been finalized.

Shen Tsai-ying, president of the Grassroots Pharmacists Association, supports the proposal, saying it could preserve patients’ medication choices and reduce the risk of originator drugs being withdrawn from Taiwan’s market. However, she recommended initially capping the balance-billing percentage at 20%, with a review after one year. Manufacturers seeking to exceed that level would be required to provide cost justifications.

She also called for stricter scrutiny of the gap between NHI reimbursement prices and hospitals’ procurement prices, to prevent hospitals from both earning procurement margins and charging patients additional fees. She further proposed including hospitals’ release of refillable prescriptions for patients with chronic illnesses for dispensing at community pharmacies in hospital accreditation criteria. A drug price gap of around 15% could serve as a starting point for discussion, taking management costs and wastage into account. Public information campaigns should begin at least three months before implementation, and receipts should clearly itemize balance-billing charges so patients understand the costs and available alternatives.

【2026-10-15／CredereMedia】